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Breastfeeding is a natural, but learned activity. The first six weeks of life are important. During this time frame, milk production is being set and the attachment that started during pregnancy is getting consolidated. While pregnant, it is normal to have questions about breastfeeding. You may be wondering how your life will be as a breastfeeding mother. Women around you may have had a variety of different experiences. So, what can you as a new mother do to make sure breastfeeding gets off to a good start?

The first thing to remember is that things are much easier if you don’t do it alone. It is really helpful to build a support network. The baby’s father is the first person who will be able to help and support you. The baby’s grandmother, other family members and close friends can be helpful as well. Let your support people know you will be breastfeeding. There are many ways they can support you and bond with your baby without having to give a bottle.

Successful breastfeeding starts with the birth. If at all possible, avoid interventions. Medical interventions during labour can have an impact on breastfeeding by affecting your hormones or the baby’s reflexes.

The first hours are important. Usually babies will have their first nursing session within the first hour after birth. Holding your baby skin to skin right after birth gives him access to the breast. Also it stabilizes his temperature, heart rate and blood sugar. Being together helps both of you recover from the birth. Your baby is adapting to life outside the womb. Those first moments are for connecting and breastfeeding; weighing and measuring the baby can wait.

Offer the baby unrestricted access to the breast. Skin to skin contact can continue to be done very often during the first days and weeks. Frequent effective feedings in the first weeks will ensure that there is plenty of milk in the months to come. Milk is created by demand and supply. The more often your baby feeds, the more milk that is made.

Alternate breasts to stimulate the supply. The supply is stimulated separately in each breast. It’s a good idea to try to nurse from both breasts at each feeding during the first weeks . This helps get both breasts producing well from the start. No need to worry if you forget occasionally, things will adjust over time. As your baby grows, he may only need one breast at a time.

You need to be close to your baby to be able to respond to his feeding cues. If the baby is in another room you will not be able to see those first movements signaling that they are ready for another nursing session. Babies show they are ready for nursing by moving their heads, licking their lips, sucking on their hands, and so on. It is much easier to feed a baby before he cries. Once your baby is crying, he will have to be calmed and comforted before a nursing session can begin. Follow the baby, not the clock. Newborn babies do not need a schedule.

Breastfeed exclusively. In the first six weeks the milk supply is being set. Any other food or liquid during this time can affect the delicate balance of demand and supply. It is recommended not to give commercial infant formula unless medically indicated.

You will also want to avoid pacifiers and bottles during the first 6 weeks. Not only can these affect your milk supply, but the baby latches on differently to an artificial nipple. This can make him latch poorly to the breast, which is a major factor in causing sore nipples.

Give yourself time. It takes time to recover from the birth, to adapt to life with a new baby, to let your baby adapt to life outside the womb. Be kind to yourself as you are learning these new skills.

Finally, it is important to remember that pain is not normal. Many women find that there is some sensitivity or discomfort in the first few days. However, if pain is increasing over the first few days or persists beyond the first week, get help. Your nurse or CHR should be able to give you some suggestions to improve the situation.

Although it may seem like a lot of work at first, breastfeeding can be pleasurable, empowering, and immensely gratifying. The effort to get things going well in the early days pays off. By following as many of these tips as you can, you will be making sure that you and your baby get breastfeeding off to a good start. You will be filled with confidence to help you along your breastfeeding journey.

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One of the wonderful things about breastfeeding is how much easier it is to get out and about with your breastfed baby.

You don’t have to worry about forgetting a bottle somewhere. You don’t have to wonder if your baby will fuss because the formula was mixed with different water. You don’t have to worry about how many supplies to bring, if you’ll have access to clean water or if you can find a way to heat up formula. And if your baby is exclusively breastfeeding, things are even easier.

You have the right to nurse your baby anywhere you are allowed to be. You don’t need to cover up or move to a secluded area. You may feel more confident about nursing in public if you choose clothes you feel comfortable in. This could be a loose T-shirt, a loose undershirt under a hoodie, a blouse you unbutton from the bottom or special nursing tops. You may find a light blanket helpful, but often those just make latching the baby more awkward. Many babies don’t like something covering their face when they are feeding.

If you are taking an airplane, breastfeeding during take-off and landing can ease the pressure in your baby’s ears. Wearing your baby in a baby carrier or wrap will make it easier to get around airports.

On a long car trip, make sure to allow for extra time for breastfeeding stops. Plan to stop as often as your baby usually feeds. You will probably need a snack and a drink yourself at that point as well. It’s important to keep your baby in the car seat while you are driving. When you stop, you can to take him out to feed him and hold him and let him change positions. I remember when my youngest child was 5 months old, I was driving from Montreal to Halifax and he was terribly unhappy in the car seat. It was tough, but we just stopped really often to make sure he was fed and comfortable and then strapped him back in and started again. Once we made it safely to our destination, we were able to enjoy all the necessary cuddles to help him adjust to being in a new place.

Breastfeeding is security. Babies that are going to a new place may find all the sights, smells and sounds confusing. It can be difficult to keep your usual routine. Mother’s breast provides a safe, familiar place for baby to relax and adjust to being in the new environment.

If you’re going somewhere crowded, be glad you’re breastfeeding! Those extra immune boosts will help protect your baby from all the new bacteria and viruses he is encountering.

If you’re headed into the bush, you will not need to worry about how to heat the baby’s milk or wonder how much to bring. Your milk is always at the right temperature and convenient.

Overall, breastfeeding makes travelling with your baby a lot easier.

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When a baby is born and placed skin-to-skin on his mother, his natural reflexes will help him find the breast and take his first drink of milk. This milk is called colostrum and is full of immune factors. Pregnant women start producing colostrum around 16 weeks of pregnancy. Every week the milk changes a little bit, adapting to the age of the fetus inside, so if your baby is born a little earlier or a little later, the milk will have the right balance of nutrients, immune and growth factors for your baby. Your baby has been receiving care and nutrients when in the womb, and colostrum is part of the way your baby’s body adapts to the outside world.

Babies need to learn to suck, swallow and breathe and to coordinate all of these activities to breastfeed well. In the first days, the smaller volume of milk is all your baby needs. This way the baby can learn to suckle well, before needing to deal with a lot of milk. The first day, on average, your baby will take in about 37ml (one and a half tablespoons) for the whole 24 hours. Some feedings the baby will only take drops of milk, other feedings he will get a larger volume. You may have heard people refer to colostrum as liquid gold, partly due to its yellowish colour, but mostly because of how precious it is.

Colostrum has strong anti-infectious properties; some people even call it baby’s first vaccine. Any other substance given in these early days, even water, can interfere with the early development of immune system. Babies given water in the first days also have an increased risk of jaundice.

As your baby wakes up more in his process of adapting to the world, on the second day of life, many babies demand to feed often. Frequent feedings don’t mean the baby isn’t getting enough. Baby’s small stomach can only accept a little at a time in the early days. Colostrum is all your baby needs.

Breastfeeding as soon as possible after birth and very often in the first few days helps to ensure an adequate milk supply. Having your baby’s suckling and latched assessed by a nurse, CHR, Elder or other knowledgeable person will help you feel confident that your baby is drinking well. Newborn babies need that important colostrum for their digestive systems, for the growth factors, immune factors and so much more.

Exclusive breastfeeding, right from birth, is the way to build your baby’s health and start him off with everything he needs. You can be confident that colostrum is enough for your baby.

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Mothers around the world wonder how what they eat will affect their baby.

When the baby is in the womb, he develops taste buds by the 13-15th week of pregnancy. The taste of the amniotic fluid changes according to the mother’s diet, so that the baby becomes used to different flavours.

When mothers are breastfeeding, a similar mechanism is taking place, allowing various proteins to get into the milk, making the milk taste somewhat different. Generally speaking, this is why babies tend to prefer food from their own culture. What the mother eats, the child experiences.

Because of this, when you eat traditional foods during pregnancy and breastfeeding, it makes it more likely that your child will enjoy them when it comes time to introduce solid foods, sometime around six months of age.

What you eat will not have a significant effect on the quality of your milk. You don’t need to eat a perfect diet to breastfeed. It may sometimes be hard to eat a well balanced diet, but if you eat a variety of nutritious foods, you will feel better yourself and your body and your baby will appreciate it. Your baby will also appreciate the variety of tastes.

There are a few nutrients that are more affected by diet than others. Although studies have shown that the amount of fat in the mother’s milk is not affected by her diet, the type of fat is. You can change the types of fat in your milk by changing the types of fats that you eat. It is best to limit processed or fast foods so that you and your baby will not be exposed to trans fats that are unhealthy. Eating a varied diet with food as close to its natural state as possible and including fish low in mercury will help ensure that you and your baby receive the healthy fats you need.

You might be wondering if there is something you can eat to make more milk. Different cultures have different beliefs about foods that increase milk supply. The only thing that has been proven to increase the milk supply is breastfeeding often and a correct latch and position.

On the other hand, most of the foods often associated with increasing milk supply are healthy foods such as oatmeal, almonds, barley, whole grains, and green leafy vegetables. These are all healthy food choices and it is fine for a breastfeeding mother to eat them.

Cree Elders recommend fish broth. This nutritious food can be a good choice as part of a mother’s varied diet. Eating foods you have heard may increase your supply can help you feel confident that you will have plenty of milk to feed your baby.

Different people may suggest that you need to avoid specific foods so that the baby doesn’t get fussy or so the milk supply doesn’t decrease. Some herbs have been shown to decrease supply. A good rule of thumb is to not take any herb in large quantities and certainly not without consulting an Elder or a traditional medicine practitioner. Ordinary quantities of herbs and spices used in cooking should be fine.

Most babies do well, no matter what the mother eats. It is rare for a food a mother eats to cause problems. Usually, if your baby is fussy, this is normal infant behaviour, and not related to what you eat. But if your baby is highly sensitive, he may have a reaction to the proteins from foods you eat that are passed on to him through your milk. You will likely notice other symptoms such as a rash, vomiting, colic, intestinal upsets or other symptoms. If you are concerned and think your baby may be reacting to a particular food, it may be helpful to eliminate that food from your diet. Speak to your nurse or CHR for more information. Babies do get fussy, and food is not always the cause. You can speak to the community nutritionist if you need help balancing your diet.

Mother’s milk does change depending on what she eats. This is one of the ways that breastfeeding provides a unique experience for the mother and her baby.

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March 6-10, 2017 is Community Wellness Week in Mistissini. The Public Health Department had an information table set up yesterday. It was an opportunity for some of my colleagues in Awash Public Health to meet with local people and explain a little bit about what we do.

Our role is promotion, prevention and surveillance of health and wellness issues. We look at the whole lifespan of a person, from pre-conception, through conception, pregnancy, birth, childhood and youth, coming full circle to the conception of the next generation. My role as PPRO Breastfeeding means that I concentrate on breastfeeding, of course, but I interact with all my colleagues so that we are sharing accurate information while helping people to make choices that will improve the health and well-being of the generations to come.

In the photos below you can see the Awash information table with books, DVDs and teaching tools on pregnancy, birth, breastfeeding and nutrition. These items are used mostly by the nurses and CHRs for teaching. Some items are given to parents to take home.

Awash public health display

One of the lovely aspects of the public health department is how we are all interconnected. We have an ongoing collaboration with Nishiiyuu to ensure that Cree traditional practices remain an integral part of our messages on improving and maintaining health and well-being. You can see the Miwat Waapiimauusun bag that is being given to women after birth on the table. It contains many traditional items used for baby care: baby wool socks, baby blanket, baby hat, waapsuuyaan (baby moss bag), belly button pouch, tummy wrap, and rotten wood powder for diaper rash. The bag is offered to the mother at the first home visit after the birth of the baby along with teachings by an Elder.

Skin-to-skin wrap

My colleagues were happy to demonstrate the baby carriers. It’s so nice to carry a baby, even if it’s only a demonstration doll! The skin-to-skin wrap is given to women during pregnancy to bring with them to the hospital. It is an excellent way to make it easier for women to hold their babies skin-to-skin and enjoy the many advantages of this practice, such as stabilizing baby’s heart and breathing rate, keeping him warm, giving him easy access to the breast for feeding and increasing attachment between the baby and family members. Dads can wear their babies skin-to-skin too!

Information about pregnancy

Participants liked being able to see this display showing the development of the fetus during pregnancy.

Baby carrier

The other baby carrier shown here can be used without needing to use your hands to hold the baby. This can be very convenient when going out and about with your breastfed baby.

With a focus on breastfeeding, perinatal education, nutrition, mental health, physical activities and Cree traditions, the Awash Public Health team is working hard to help build a healthy community. The community wellness day was well received by participants and the public health team was pleased to share messages and tools that will enable everyone to enjoy their highest potential Myupmaatsuinn (well-being).

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Around the world, Breastfeeding week is celebrated through activities and events to promote and protect breastfeeding. World Breastfeeding Week is held in August in many parts of the world and in October in Canada. In Eeyou Itschee, Breastfeeding Week may be celebrated in November, or sometimes in March to correspond with Nutrition Month.

Last November, Waskaganish nutritionists and CHRs had their Breastfeeding week with activities to promote breastfeeding in the community. The activities involved many members of the community of all ages.

One of the activities took place at the daycare. CHRs read a book called “The Wonders of Mother’s Milk” by Mishawn Purnell-O’Neal to the children. This activity was well appreciated.

Another activity was a radio show with a Breastfeeding Trivia Contest and Testimonials. People called in and answered trivia questions about breastfeeding for the chance to win a prize. There were also testimonials by Elders and listeners enjoyed the personal anecdotes.

The third activity held was an art contest. The nutritionist described the art contest as follows:

An art contest was open to all students at Annie Whiskeychan Memorial Elementary School. Announcements were made in every classroom of elementary school during the week to invite the kids to draw a picture or colour a pre-made outline related to the theme of breastfeeding. The CHRs also read a story about breastfeeding in the pre-K and kindergarten classrooms. The children had 1 week to submit their creations to their teacher. Drawings/pictures were posted on the clinic walls during breastfeeding week and all community members were invited to vote for their two of their favourites in each of the three groups (pre-K, grade 1, and grade 3).

I have included photos of some of the winning drawings in the blog. What a great idea to help normalize breastfeeding by planning events for school aged children. Breastfeeding needs to be supported by the whole community and the whole community’s health is influenced by breastfeeding. Waskaganish Breastfeeding Week was a success and thank you to all the participants!

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As breastfeeding consultant for Public Health one of my roles is to visit communities to offer support and training to the health care workers. This past week I made my first visit to Waswanipi. I went along with the nurse counselor from Public Health. We were very warmly received. It was enjoyable to hear from the workers what they saw as the strengths of their community, and how we could help them to deal with some of the challenges to supporting families in the perinatal period, and for me particularly, to hear about how they support families on their breastfeeding journey.

During the course of this visit, I got to visit the Cultural Centre and have some traditional food for lunch. It was a gorgeous sunny day and we enjoyed walking around the community and getting a feel for the people and the nice view of the tiipii at the Cultural Centre.

At the end of the training day, the workers seemed more confident in their knowledge about prenatal care, birth and breastfeeding and will certainly be passing along their new information to the families in Waswanipi.

During the training, we watched a number of videos, including one that has been shared on Cree Breastfeeding before, but that is worth sharing again. The Creator’s Gift to Mothers is a lovely video that can be watched by pregnant women, by grandmothers, partners and anyone in the community that wants to know a little bit more about the importance of breastfeeding. Enjoy!

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Some of you may have heard that the Cree Nation Government adopted the Framework for Action to Improve Access to Nutritious Food in Eeyou Istchee. On Tuesday, January 24th, of this year, Dr. Darlene Kitty and Bella Petawabano gave a presentation on Access to Nutritious Food in Eeyou Istchee at the Cree Nation Government Council Board meeting. Their presentation was broadcast live on regional radio and livestream. Links to the broadcast are included at the end of this post.

This is a call to action for all communities. Breastfeeding plays a key role in ensuring that the youngest members of the community have food security. Breastmilk is baby’s first food.

Food security means having enough food to maintain a healthy and productive life today–and in the future. Communities enjoy food security when all individuals in all households have access to food–adequate in quantity and quality, affordable, acceptable, appropriate and readily available from local sources on a continuing basis.1

If we look at this closely, we see that breastfeeding fulfills all the requirements.

Having enough food to maintain a healthy and productive life today:

Breastfeeding contains all the essential nutrients to support the development of the baby for the first six months of life. Not only that but it contains immune factors that protect the baby against common illnesses and chronic diseases, giving the baby protection throughout his lifespan.

Adequate in quantity & quality :

With support and information most women can produce plenty of milk for their baby. Some women provide enough for twins or more! Human milk is a high quality food even when the mother’s diet is less than ideal.

Affordable :

Breastfeeding costs very little while artificial infant milk (formula) can represent a significant portion of a family’s income. Breastfeeding allows the family to use more resources for nutritious foods for the whole family. Feeding the mother also feeds the baby.

Acceptable :

Breastfeeding is part of Cree culture and an important contribution to Myuupmasitsiun.

“Our children were always told to breast feed their children even when milk became available at the store. “When God gave you a baby,” my father used to tell them, “He also gave you the equipment to feed that baby, so use what God gave you.” And they followed his teachings.”(Mary George: Whapmagostui: 2012)

Readily available from local sources on a continuing basis.

The baby’s own mother is the most local of sources. As long as the baby demands, more milk will be produced. Recommendations are to continue breastfeeding for two years or more, after the introduction of complimentary foods at around six months. “Cree Elders recommend that women breastfeed their babies as long as they can! They say that breastfeeding is Love.”2

A few more thoughts on food security and breastfeeding:

As well as security for the baby, breastfeeding contributes to a mother’s food security by lowering her risk of nutritionally demanding diseases, such as osteoporosis and anemia.

Communities benefit when everybody experiences food security. When a community is well fed, resources can be used for needs other than food. Community programs to reduce hunger and provide access to nutritious foods won’t need to use their funds on artificial infant milk (formula) when babies enrolled in the program are breastfed.

It is important to remember that breastfeeding is more than just a way to get nutritious and disease-fighting food into the baby. A breastfed baby enjoys not only food security, but also a wonderful feeling of security through that feeding. Babies thrive on human touch, and feeding the food nature intended also provides the skin-to-skin contact so necessary to the psychological development of a young baby.

It is up to all of us to make sure that the youngest members of our community receive the truest security.

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When my first child was 21 months old, I found out I was pregnant again. This was news that I greeted with pleasure. I was still breastfeeding my son and was wondering how it would go. Would I nurse through the pregnancy or would I wean him? I knew quite a few breastfeeding mothers at that point and some continued to nurse through their pregnancy while others chose to wean. How would I decide which was right for us?

My son was a very active, busy toddler and I found that breastfeeding soothed so many small ills, that I didn’t really want to stop. I knew that by stopping completely, I would have to work really hard to replace everything that breastfeeding meant to him. I remember going to a support group when he was just over a year and the support group leader listed all the things breastfeeding could be: food, drink, comfort, warmth, security, fun and games, routine, immune protection, medicine and so on. I knew it was helpful for soothing hurt feelings and when he got sick, all he wanted to drink was my milk. I knew that if I was to wean him, I would have to work harder at mothering him. For me the right decision was to continue breastfeeding.

I had a few normal worries. How would breastfeeding affect the developing fetus? I did a little bit of reading and found out that breastfeeding would not deprive the new baby of any nutrients. I would have to take even more care of myself and make sure I was eating well and enough and getting enough rest.

My body was changing. In the first trimester my nipples were more sensitive, so I decided to cut down on the length of time of our nursing sessions and also not offer the breast, but wait until he asked. However, sitting or lying down to nurse him when I was tired was a good way of looking after an active toddler and dealing with my own normal fatigue from pregnancy.

By the second trimester, I was starting to feel more energetic and wasn’t suffering from nipple sensitivity quite as much. It wasn’t always easy or comfortable to continue nursing, and sometimes I would feel restless while nursing. In my case the numerous benefits of continuing to breastfeed far outweighed the drawbacks.

By the third trimester, the volume of milk available for my toddler was much less. The milk had switched to colostrum in preparation for my new baby. My son became much less interested in nursing at that point and I thought he might wean altogether. I was still nursing him to sleep and once during the day. I was happy to know that breastfeeding would not send me into early labour. Only women who have risk factors for early labour may be told to wean. My health care provider told me that breastfeeding is far less likely than sex to start labour, so unless I was told to stop having sex, well I could continue to feed my toddler. By the end of my pregnancy I was hoping that the stimulation of the nipples might actually start to work and get labour going! That didn’t end up being the case, but I did have a smooth birth and gave birth to a lovely 4.5kg baby girl. She certainly wasn’t lacking in any nutrients! My nursing toddler had a baby sister and a new chapter of my motherhood began.